在机械血栓切除术后检测到的左心室附属体血栓的连续栓塞事件:病例报告和管理考虑
Satoshi Horiguchi1, Yoshinori Maki2, Yusuke Kobayashi3
1Department of Neurosurgery, Nagahama City Hospital, Nagahama, JPN.
Cureus
|November 24, 2025
概括
进行中风血栓切除术的心房患者可能隐藏着左心房附属体血栓. 通过CT早期检测至关重要,因为拒绝抗凝剂可以导致重复性中风.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 放射学 放射学是一门学科.
背景情况:
- 心房动 (AF) 是缺血性中风的主要原因.
- 左心房附属体 (LAA) 是AF患者中风引起血栓的主要来源.
- 在急性中风血栓切除术后检测LAA血栓是罕见的,但至关重要.
研究的目的:
- 在中风患者中报告了一种罕见的LAA血栓在血栓切除术后发现的病例.
- 突出在患有LAA血栓的AF患者中中风后管理抗凝血的挑战.
- 强调LAA血栓检测对于二次中风预防的重要性.
主要方法:
- 一个82岁的女性患有AF的病例报告,呈现出急性内动脉 (ICA) 堵塞.
- 进行机械血栓切除术以获得成功的再输血.
- 与对比度增强的胸部CT检测出LAA血栓;MRI显示复发的ICA封闭.
主要成果:
- 一次成功的初始血栓切除术 (TICI 2b),随后检测到LAA血栓.
- 在停止抗凝药后,由于LAA血栓出现了反复复发的左ICA封闭.
- 患者经历重度残疾 (mRS 5) 尽管重复血栓切除术 (TICI 2a).
结论:
- 增强对比度的CT对于检测急性中风血栓切除患者的LAA血栓至关重要.
- 由于出血转化而延迟的抗凝血增加了复发性栓塞事件的风险.
- 在AF中,LAA阻塞评估和管理策略对于二次中风预防至关重要.
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